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ORIGINAL ARTICLE01-10-2024
Micro and macropolitical determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte
Revista Brasileira de Enfermagem. 2024;77:e20230235
Abstract
ORIGINAL ARTICLEMicro and macropolitical determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte
Revista Brasileira de Enfermagem. 2024;77:e20230235
DOI 10.1590/0034-7167-2023-0235
Views0See moreABSTRACT
Objective:
To analyze the determinants for non-vaccination against COVID-19 in pregnant women in Belo Horizonte, Minas Gerais, Brazil.
Methods:
An epidemiological study with a cross-sectional design was conducted using data from the project titled “Childbirth and Breastfeeding in Children of Mothers Infected by SARS-CoV-2,” developed during the pandemic in the city of Belo Horizonte, Minas Gerais, Brazil.
Results:
The study sample consisted of 360 pregnant women, of whom 77.89% received the COVID-19 vaccine. External, social, and institutional determinants can influence lower adherence to COVID-19 vaccination, especially the absence of employment during pregnancy, difficult access to prenatal consultations, and a compromised or deficient support network.
Conclusions:
In light of this scenario, greater encouragement for health education is necessary, especially during prenatal care, resulting in lower rates of morbidity and mortality and favorable perinatal outcomes.
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ORIGINAL ARTICLE01-10-2024
COVID-19: Training activities, adherence, and use of personal protective equipment in Primary Health Care
Revista Brasileira de Enfermagem. 2024;77:e20230179
Abstract
ORIGINAL ARTICLECOVID-19: Training activities, adherence, and use of personal protective equipment in Primary Health Care
Revista Brasileira de Enfermagem. 2024;77:e20230179
DOI 10.1590/0034-7167-2023-0179
Views0ABSTRACT
Objective:
to analyze the association between participation in training activities and the adherence to and use of personal protective equipment by workers and professionals involved in Health Residency Programs in Primary Health Care during the COVID-19 pandemic.
Methods:
a cross-sectional study in Brazil between August/2020 and March/2021. We utilized the EPI-APS COVID-19 instrument and its adapted version for resident professionals.
Results:
455 PHC workers and 102 residents participated in the study. Among them, 54.5% and 55.9%, respectively, engaged in training activities. We observed an association between participation in training activities and the proper use of gloves (p<0.001), gowns (p=0.009), goggles/face shields (p=0.002), and overall adherence (p<0.001) among PHC workers, and the proper use of surgical masks (p=0.028) among residents. Adherence rates of ≥75% were identified in 6.9% of PHC workers and none among the residents.
Conclusion:
training activities are associated with increased adherence to and proper use of PPE.
Keywords:COVID-19Health PersonnelPersonal Protective EquipmentPrimary Health CareTraining ActivitiesSee more -
ORIGINAL ARTICLE12-16-2024
Software for the care of people with cardiovascular risk: construction and evidence of validity
Revista Brasileira de Enfermagem. 2024;77(6):e20240276
Abstract
ORIGINAL ARTICLESoftware for the care of people with cardiovascular risk: construction and evidence of validity
Revista Brasileira de Enfermagem. 2024;77(6):e20240276
DOI 10.1590/0034-7167-2024-0276
Views0See moreABSTRACT
Objectives:
to build and validate software for the care of people with cardiovascular risk.
Methods:
a methodological study, applied to software development, anchored in a nursing theory and classification system, in three stages: 1) requirements engineering; 2) software architecture and coding; and 3) testing and content validity by 12 experts in computer science, with a Content Validity Ratio score.
Results:
called e-TEORISC, in software format, for nursing care for people with cardiovascular risk, online and offline, containing a database linked to the Nursing Process stages. Experts considered that the attributes of functional suitability, performance efficiency, reliability, maintainability, usability, safety and portability obtained desirable scores.
Conclusions:
e-TEORISC has evidence of validity to instrumentalize care for people at cardiovascular risk, with potential for technology transfer to the Brazilian Health System.
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ORIGINAL ARTICLE12-16-2024
Sleep quality of patients with heart failure and associated factors
Revista Brasileira de Enfermagem. 2024;77(6):e20240244
Abstract
ORIGINAL ARTICLESleep quality of patients with heart failure and associated factors
Revista Brasileira de Enfermagem. 2024;77(6):e20240244
DOI 10.1590/0034-7167-2024-0244
Views0See moreABSTRACT
Objectives:
to assess sleep quality of patients with heart failure and associated sociodemographic and clinical characteristics.
Methods:
a cross-sectional study, developed with 88 patients. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive and inferential statistics.
Results:
the mean sleep quality score was 8.59 ± 3.60 points. 83% of participants were classified as poor sleepers. The number of hours of sleep was 5.99 ± 1.48. Family income of up to one minimum wage and functional class were significantly associated with poor sleepers. There was a positive correlation between functional class and poor sleep quality.
Conclusions:
a high frequency of poor sleepers was identified. Worse scores were associated with family income and symptomatic functional class. Health interventions are necessary to control sleep quality, especially in relation to health functionality.
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ORIGINAL ARTICLE12-16-2024
Religión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
Abstract
ORIGINAL ARTICLEReligión y experiencia profesional: ¿Serán predictores de la inteligencia espiritual de los enfermeros? Estudio transversal
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
DOI 10.1590/0034-7167-2024-0217es
Views0See moreRESUMEN
Objetivos:
analizar la relación entre religión y experiencia profesional con la inteligencia espiritual en enfermeros.
Métodos:
estudio transversal y analítico realizado en 2021, participaron 544 profesionales de enfermería que laboraban en establecimiento de salud de Perú durante la pandemia por COVID-19. Para el análisis de los datos se emplearon el análisis de regresión múltiple y correlación de Pearson.
Resultados:
en los enfermeros predominó un nivel de inteligencia espiritual saludable (42,8%). Quienes no profesaban una religión tenían mayor probabilidad de tener menor puntaje de inteligencia espiritual (escala global y dimensiones); sin embargo, los enfermeros expertos tuvieron mayor probabilidad de tener mayor inteligencia espiritual (escala global y dimensiones) que los enfermeros novatos (p<0,05).
Conclusiones:
la inteligencia espiritual en los enfermeros fue predicha por la religión y la experiencia profesional. Este hallazgo sugiere que la inteligencia espiritual en enfermería se consolida mediante prácticas religiosas y durante el ejercicio profesional.
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ORIGINAL ARTICLE12-16-2024
Religion and professional experience: Are they predictors of nurses’ spiritual intelligence? Cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
Abstract
ORIGINAL ARTICLEReligion and professional experience: Are they predictors of nurses’ spiritual intelligence? Cross-sectional study
Revista Brasileira de Enfermagem. 2024;77(6):e20240217
DOI 10.1590/0034-7167-2024-0217
Views0See moreABSTRACT
Objectives:
to analyze the relationship between religion and professional experience with spiritual intelligence in nurses
Methods:
cross-sectional and analytical study carried out in 2021, with the participation of 544 nursing professionals working in health facilities in Peru during the COVID-19 pandemic. Multiple regression analysis and Pearson’s correlation were used to analyze the data.
Results:
in nurses, a healthy level of spiritual intelligence predominated (42.8%). Those who did not profess a religion were more likely to have a lower spiritual intelligence score (global scale and dimensions); however, experienced nurses were more likely to have higher spiritual intelligence (global scale and dimensions) than novice nurses (p<0.05).
Conclusions:
spiritual intelligence in nurses was predicted by religion and professional experience. This finding suggests that spiritual intelligence in nursing is consolidated through religious practices and during professional practice.
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ORIGINAL ARTICLE12-16-2024
Effectiveness of the modified Seldinger technique for peripheral central catheter in newborns: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(6):e20240189
Abstract
ORIGINAL ARTICLEEffectiveness of the modified Seldinger technique for peripheral central catheter in newborns: a randomized clinical trial
Revista Brasileira de Enfermagem. 2024;77(6):e20240189
DOI 10.1590/0034-7167-2024-0189
Views0ABSTRACT
Objectives:
to evaluate the effectiveness of peripheral central catheterization by comparing the modified Seldinger technique and the conventional technique in critically ill newborns.
Methods:
randomized unmasked clinical trial conducted in a public children’s hospital. Participation of 111 newborns with randomized allocation, 56 in the control group (conventional technique) and 55 in the experimental group (modified Seldinger). Success and absence of complications were evaluated as primary outcomes. The pain scale, difficulty in hemostasis, procedure time and number of punctures were considered secondary outcomes.
Results:
there was no statistical significance between groups, either for success (p=0.705) or absence of complications (p=0.347). A lower pain score, improved hemostasis, increased assertiveness with fewer punctures and reduced procedure time were not observed in the experimental group.
Conclusions:
the modified Seldinger technique did not prove to be a more effective insertion technology compared to the conventional method. Brazilian Clinical Trial Registry: RBR-69vks36.
Keywords:Comparative Effectiveness ResearchNewbornPeripheral CatheterizationRandomized Controlled TrialTechnologySee more -
ORIGINAL ARTICLE12-16-2024
Narratives of sex workers: intimate partner violence and coping strategies
Revista Brasileira de Enfermagem. 2024;77(6):e20240180
Abstract
ORIGINAL ARTICLENarratives of sex workers: intimate partner violence and coping strategies
Revista Brasileira de Enfermagem. 2024;77(6):e20240180
DOI 10.1590/0034-7167-2024-0180
Views0See moreABSTRACT
Objectives:
to understand the narratives of sex workers about violence suffered by intimate partners and their coping strategies.
Methods:
qualitative research, focused on thematic oral history, carried out with six sex workers in southern Brazil, who responded to in-depth interviews using a flexible script. Thematic content analysis was used.
Results:
the study included cisgender women who self-identified as half black and half white. Most had children and were separated. They reported abusive relationships by their intimate partners, with emphasis on verbal, psychological, financial, and physical violence and attempted femicide. Such violence resulted in coping strategies, such as avoiding emotional bonds and maintaining a discreet life.
Final Considerations:
intimate partner violence is prevalent among participants, leading them to adopt strategies to preserve their safety and well-being, highlighting the need for public policies that meet their particularities and guarantee protection.
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RESEARCH01-01-2016
Prevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
Abstract
RESEARCHPrevention and monitoring of delirium in older adults: an educational intervention
Revista Brasileira de Enfermagem. 2016;69(4):725-732
DOI 10.1590/0034-7167.2016690416i
Views0See moreABSTRACT
Objective:
to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients.
Method:
this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil.
Results:
ten problems regarding nursing practices for prevention and monitoring of delirium were identified. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported significant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation.
Conclusion:
the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments.
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RESEARCH01-01-2016
Technology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
Abstract
RESEARCHTechnology-dependent children and the demand for pharmaceutical care
Revista Brasileira de Enfermagem. 2016;69(4):718-724
DOI 10.1590/0034-7167.2016690415i
Views0See moreABSTRACT
Objective:
to understand the experience of mothers of technology-dependent children as regards pharmaceutical care.
Method:
this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis.
Results:
this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks.
Conclusion:
pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.
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RESEARCH01-01-2016
Fasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
Abstract
RESEARCHFasting of less than eight hours in urgent and emergency surgeries versus complication
Revista Brasileira de Enfermagem. 2016;69(4):712-717
DOI 10.1590/0034-7167.2016690414i
Views0See moreABSTRACT
Objective:
to verify the occurrence of intraoperative and postoperative complications in patients undergoing urgent and emergency surgical procedures between January and December 2012, with fasting time of less than 8 hours.
Method:
a quantitative study was conducted, of the retrospective cohort type, through the analysis of medical records.
Results:
we included 181 records of patients undergoing surgical procedures with average duration of 59.4 minutes. Fractures correction surgeries stood out, totalling 32% of cases. We observed complications in 36 patients (19.9%), vomiting being the most prevalent (47.2%); followed by nausea (16.7%); need for blood transfusion (13.9%); surgical site infection (11.1%); and death (11.1%). The average fasting time was 133.5 minutes. The fasting time showed no statistically significant correlation with the complications investigated.
Conclusion:
intraoperative and postoperative complications were associated with the clinical conditions of the patients and not with the fasting time.
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RESEARCH01-01-2016
Validation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
Abstract
RESEARCHValidation to Portuguese of the Debriefing Experience Scale
Revista Brasileira de Enfermagem. 2016;69(4):705-711
DOI 10.1590/0034-7167.2016690413i
Views1See moreABSTRACT
Objective:
to translate and validate to Portuguese the Debriefing Experience Scale jointly with individuals that used high-fidelity simulation in learning.
Method:
methodological and exploratory study for an instrument translation and validation. For the validation process, the event “III Workshop Brazil – Portugal: Care Delivery to Critical Patients” was created.
Results:
103 nurses attended. Validity and reliability of the scale, the correlation pattern among variables, the sampling adequacy test, and the sphericity test showed good results. Since there was no relationship among the groups established in the exploratory factor analysis, the option was to follow the division established by the original version.
Conclusion:
the version of the instrument was called Escala de Experiência com o Debriefing. The results showed good psychometric properties and a good potential for use. However, further studies will contribute to consolidate the validity of the scale and strengthen its potential use.
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RESEARCH01-01-2016
Factor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
Abstract
RESEARCHFactor analysis of an instrument to measure the impact of disease on daily life
Revista Brasileira de Enfermagem. 2016;69(4):697-704
DOI 10.1590/0034-7167.2016690412i
Views0See moreABSTRACT
Objective:
to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients.
Method:
the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach’s alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance.
Conclusion:
future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.
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RESEARCH01-01-2016
Associação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
RESEARCHAssociação da fragilidade em idosos internados e institucionalizados na comunidade
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreRESUMEN
Objetivo:
investigar la asociación entre la fragilidad y la internación e institucionalización, en un estudio de acompañamiento de residentes ancianos.
Método:
el estudio de acompañamiento fue realizado en 2008 y 2013, con ancianos de ambos sexos, de 65 años o más, los cuales vivían en la comunidad. El procedimiento de muestreo realizado fue probabilístico, con agrupamiento en dos etapas. Fueron entrevistados 512 ancianos en 2008 y 262 en 2013. Datos socioeconómicos y demográficos, morbilidad relatada por los mismos y datos específicos de internación e institucionalización han sido utilizados. La fragilidad fue medida por la escala Edmond Frail Scale (EFS) y la capacidad funcional por la escala Functional Independence Measure (FIM).
Resultados:
El promedio de la puntuación EFS fue mayor entre los residentes ancianos que fueron internados y hospitalizados, siendo estadísticamente significativa en los dos años investigados.
Conclusión:
La confirmación de la asociación entre la fragilidad y la internación e institucionalización refuerza la importancia del tema y enfatiza la fragilidad como un instrumento importante en la evaluación de los riesgos para estos eventos adversos.
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RESEARCH01-01-2016
Association of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
Abstract
RESEARCHAssociation of frailty in hospitalized and institutionalized elderly in the community-dwelling
Revista Brasileira de Enfermagem. 2016;69(4):691-696
DOI 10.1590/0034-7167.2016690411i
Views0See moreABSTRACT
Objective:
to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents.
Method:
the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specific data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure.
Results:
we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically significant in both investigated years.
Conclusion:
the confirmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.
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RESEARCH01-01-2016
Analysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
Abstract
RESEARCHAnalysis of managerial and healthcare indicators after nursing personnel upsizing
Revista Brasileira de Enfermagem. 2016;69(4):684-690
DOI 10.1590/0034-7167.2016690410i
Views0ABSTRACT
Objective:
analyze healthcare and managerial indicators after nursing personnel upsizing.
Method:
a retrospective, descriptive study was conducted using data from computer systems of a university hospital in southern Brazil. Healthcare and managerial indicators related to the first half of 2013 and 2014 were statistically analyzed.
Results:
increases of 40.0% in the number of nurses and 16.0% in the number of nursing technicians led to reductions of 12.0% in the number of sickness absences, 21.8% in positive balance for compensatory time off, 92.0% in paid overtime. Reductions of 75.0% in pressure ulcer rates, 10.5% in the number of falls and 50.0% in infections due to indwelling catheter use were also observed.
Conclusion:
nursing staff upsizing caused a positive impact on managerial and healthcare indicators and helped qualify care and improve work conditions for the nursing team.
Keywords:AbsenteeismHealth Care Quality IndicatorsHospital Nursing StaffHospital Personnel AdministrationPatient SafetySee more
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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0ABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
ORIGINAL ARTICLEMetodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0RESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0ABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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